1
|
Veronese N, Nova A, Fazia T, Riggi E, Yang L, Piccio L, Huang BH, Ahmadi M, Barbagallo M, Notarnicola M, Giannelli G, De Pergola G, Stamatakis E, Cereda E, Bernardinelli L, Fontana L. Contribution of Nutritional, Lifestyle, and Metabolic Risk Factors to Parkinson's Disease. Mov Disord 2024. [PMID: 38532309 DOI: 10.1002/mds.29778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Modifiable risk factors for Parkinson's disease (PD) are poorly known. OBJECTIVES The aim is to evaluate independent associations of different nutritional components, physical activity, and sedentary behavior and metabolic factors with the risk of PD. METHODS In this population-based prospective cohort study using the data of the United Kingdom Biobank (from 2006-2010), 502,017 men and women who were free from PD (International Classification of Diseases 10th edition; "G20") at baseline were included. We implemented a Cox proportion hazard's model to evaluate the associations of different levels of physical activity, sitting time, sleep habits, diet quality, alcohol and coffee consumption, smoking, and body mass index with PD risk, adjusting for several confounding variables. RESULTS During a median follow-up of 12.8 years, lifestyle factors including vigorous physical activity (hazard ration [HR] = 0.84; 95% confidence interval [CI], 0.75-0.94), low-to-moderate sitting time (HR = 0.89; 95% CI, 0.81-0.97), and high sleep quality (HR = 0.89; 95% CI, 0.80-0.99) were associated with a reduced risk of PD. Small amounts of coffee (HR = 0.88; 95% CI, 0.82-0.95), red meat (HR = 0.86; 95% CI, 0.76-0.97), and current smoking (HR = 0.65; 95% CI, 0.56-0.75) were also associated with a lower risk of PD, whereas alcohol intake (HR = 1.29; 95% CI, 1.06-1.56) with higher PD risk. Secondary analysis, including metabolic risk factors, confirmed these findings and highlighted the potential protective effect of plasma vitamin D and uric acid, but of low-density lipoprotein-cholesterol, triglycerides, and C-reactive protein as well. CONCLUSIONS Vigorous physical activity, reduced sitting time, good sleep quality together with small coffee intake and vitamin D supplementation are potentially neuroprotective lifestyle interventions for the prevention of PD. © 2024 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Andrea Nova
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Teresa Fazia
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Emilia Riggi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Lin Yang
- Cancer Epidemiology and Prevention Research Alberta Health Services-Cancer Care Alberta, Calgary, Alberta, Canada
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Laura Piccio
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Bo-Huei Huang
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Matthew Ahmadi
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Maria Notarnicola
- National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Giovanni De Pergola
- National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, Italy
| | - Emmanuel Stamatakis
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Fondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Luigi Fontana
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Giorgi Rossi P, Mancuso P, Pattacini P, Campari C, Nitrosi A, Iotti V, Ponti A, Frigerio A, Correale L, Riggi E, Giordano L, Segnan N, Di Leo G, Magni V, Sardanelli F, Fornasa F, Romanucci G, Montemezzi S, Falini P, Auzzi N, Zappa M, Ottone M, Mantellini P, Duffy SW, Armaroli P, Coriani C, Pescarolo M, Stefanelli G, Tondelli G, Beretti F, Caffarri S, Marchesi V, Canovi L, Colli M, Boschini M, Bertolini M, Ragazzi M, Pattacini P, Giorgi Rossi P, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Campari C, Caroli S, Nitrosi A, Braglia L, Cavuto S, Mancuso P, Djuric O, Venturelli F, Vicentini M, Braghiroli MB, Lonetti J, Davoli E, Bonelli E, Fornasa F, Montemezzi S, Romanucci G, Lucchi I, Martello G, Rossati C, Mantellini P, Ambrogetti D, Iossa A, Carnesciali E, Mazzalupo V, Falini P, Puliti D, Zappa M, Battisti F, Auzzi N, Verdi S, Degl'Innocenti C, Tramalloni D, Cavazza E, Busoni S, Betti E, Peruzzi F, Regini F, Sardanelli F, Di Leo G, Carbonaro LA, Magni V, Cozzi A, Spinelli D, Monaco CG, Schiaffino S, Benedek A, Menicagli L, Ferraris R, Favettini E, Dettori D, Falco P, Presti P, Segnan N, Ponti A, Frigerio A, Armaroli P, Correale L, Marra V, Milanesio L, Artuso F, Di Leo A, Castellano I, Riggi E, Casella D, Pitarella S, Vergini V, Giordano L, Duffy SW, Graewingholt A, Lang K, Falcini F. Comparing accuracy of tomosynthesis plus digital mammography or synthetic 2D mammography in breast cancer screening: baseline results of the MAITA RCT consortium. Eur J Cancer 2024; 199:113553. [PMID: 38262307 DOI: 10.1016/j.ejca.2024.113553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/01/2024] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
AIM The analyses here reported aim to compare the screening performance of digital tomosynthesis (DBT) versus mammography (DM). METHODS MAITA is a consortium of four Italian trials, REtomo, Proteus, Impeto, and MAITA trial. The trials adopted a two-arm randomised design comparing DBT plus DM (REtomo and Proteus) or synthetic-2D (Impeto and MAITA trial) versus DM; multiple vendors were included. Women aged 45 to 69 years were individually randomised to one round of DBT or DM. FINDINGS From March 2014 to February 2022, 50,856 and 63,295 women were randomised to the DBT and DM arm, respectively. In the DBT arm, 6656 women were screened with DBT plus synthetic-2D. Recall was higher in the DBT arm (5·84% versus 4·96%), with differences between centres. With DBT, 0·8/1000 (95% CI 0·3 to 1·3) more women received surgical treatment for a benign lesion. The detection rate was 51% higher with DBT, ie. 2·6/1000 (95% CI 1·7 to 3·6) more cancers detected, with a similar relative increase for invasive cancers and ductal carcinoma in situ. The results were similar below and over the age of 50, at first and subsequent rounds, and with DBT plus DM and DBT plus synthetic-2D. No learning curve was appreciable. Detection of cancers >= 20 mm, with 2 or more positive lymph nodes, grade III, HER2-positive, or triple-negative was similar in the two arms. INTERPRETATION Results from MAITA confirm that DBT is superior to DM for the detection of cancers, with a possible increase in recall rate. DBT performance in screening should be assessed locally while waiting for long-term follow-up results on the impact of advanced cancer incidence.
Collapse
Affiliation(s)
| | | | | | - Cinzia Campari
- Screening coordinating centre, AUSL - IRCCS di Reggio Emilia, Italy
| | - Andrea Nitrosi
- Medical Physics unit, AUSL - IRCCS di Reggio Emilia, Italy
| | | | - Antonio Ponti
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Alfonso Frigerio
- SSD Senologia di Screening AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Loredana Correale
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Emilia Riggi
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Livia Giordano
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Nereo Segnan
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Giovanni Di Leo
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesco Sardanelli
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Patrizia Falini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Noemi Auzzi
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marco Zappa
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marta Ottone
- Epidemiology Unit, AUSL - IRCCS di Reggio Emilia, Italy
| | - Paola Mantellini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Paola Armaroli
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Ilaria Lucchi
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Gessica Martello
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Di Leo
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Veronica Magni
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Andrea Cozzi
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Diana Spinelli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | - Adrienn Benedek
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Laura Menicagli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Axel Graewingholt
- Mammographiescreening-Zentrum Paderborn, Breast Cancer Screening, Paderborn, NRW, Germany
| | - Kristina Lang
- Departement of Translational Medicine, Lund University, Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | | |
Collapse
|
3
|
Santos JA, Riggi E, Grant R, Ingale S, Bhaumik S, Di Tanna GL. Bayesian approach for meta-analyses in biomedical research: a scoping review protocol. JBI Evid Synth 2024; 22:447-452. [PMID: 38328979 DOI: 10.11124/jbies-23-00430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The overarching aim of this scoping review is to describe and analyze the scope of use and reporting of Bayesian methods in meta-analyses in biomedical research. INTRODUCTION The Bayesian approach provides a powerful and flexible framework for meta-analysis, particularly suited for dealing with complex, sparse, or heterogeneous data. Due to these advantages and its appeal, Bayesian methods have been increasingly used in many areas of biomedical research; however, their use in meta-analysis remains scarce. INCLUSION CRITERIA This review will include studies that used Bayesian methods for meta-analysis of primary studies in biomedical research. METHODS The proposed review will be conducted in accordance with the JBI methodology for scoping reviews. PubMed, Embase, CINAHL, and the Cochrane Database of Systematic Reviews will be searched to identify relevant full-text papers published since 2016 in English. No geographical restriction will be applied. Two reviewers will screen the articles and extract the data using a tool that will be pilot-tested and revised, as necessary. Analysis will involve frequency counts, narrative synthesis, and mapping concepts to propose an appropriate workflow. The details of the scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline. REVIEW REGISTRATION Open Science Framework https://osf.io/jenp4/.
Collapse
Affiliation(s)
- Joseph Alvin Santos
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Ticino, Switzerland
| | - Emilia Riggi
- Epidemiology and Screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Robert Grant
- BayesCamp Ltd, Winchester, UK
- Kingston University, London, UK
| | - Samiksha Ingale
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, New Delhi, India
| | - Soumyadeep Bhaumik
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, New Delhi, India
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, UNSW Sydney, Australia
| | - Gian Luca Di Tanna
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Ticino, Switzerland
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, UNSW Sydney, Australia
| |
Collapse
|
4
|
Chiorino G, Petracci E, Sehovic E, Gregnanin I, Camussi E, Mello-Grand M, Ostano P, Riggi E, Vergini V, Russo A, Berrino E, Ortale A, Garena F, Venesio T, Gallo F, Favettini E, Frigerio A, Matullo G, Segnan N, Giordano L. Plasma microRNA ratios associated with breast cancer detection in a nested case-control study from a mammography screening cohort. Sci Rep 2023; 13:12040. [PMID: 37491482 PMCID: PMC10368693 DOI: 10.1038/s41598-023-38886-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
Mammographic breast cancer screening is effective in reducing breast cancer mortality. Nevertheless, several limitations are known. Therefore, developing an alternative or complementary non-invasive tool capable of increasing the accuracy of the screening process is highly desirable. The objective of this study was to identify circulating microRNA (miRs) ratios associated with BC in women attending mammography screening. A nested case-control study was conducted within the ANDROMEDA cohort (women of age 46-67 attending BC screening). Pre-diagnostic plasma samples, information on life-styles and common BC risk factors were collected. Small-RNA sequencing was carried out on plasma samples from 65 cases and 66 controls. miR ratios associated with BC were selected by two-sample Wilcoxon test and lasso logistic regression. Subsequent assessment by RT-qPCR of the miRs contained in the selected miR ratios was carried out as a platform validation. To identify the most promising biomarkers, penalised logistic regression was further applied to candidate miR ratios alone, or in combination with non-molecular factors. Small-RNA sequencing yielded 20 candidate miR ratios associated with BC, which were further assessed by RT-qPCR. In the resulting model, penalised logistic regression selected seven miR ratios (miR-199a-3p_let-7a-5p, miR-26b-5p_miR-142-5p, let-7b-5p_miR-19b-3p, miR-101-3p_miR-19b-3p, miR-93-5p_miR-19b-3p, let-7a-5p_miR-22-3p and miR-21-5p_miR-23a-3p), together with body mass index (BMI), menopausal status (MS), the interaction term BMI * MS, life-style score and breast density. The ROC AUC of the model was 0.79 with a sensitivity and specificity of 71.9% and 76.6%, respectively. We identified biomarkers potentially useful for BC screening measured through a widespread and low-cost technique. This is the first study reporting circulating miRs for BC detection in a screening setting. Validation in a wider sample is warranted.Trial registration: The Andromeda prospective cohort study protocol was retrospectively registered on 27-11-2015 (NCT02618538).
Collapse
Affiliation(s)
- Giovanna Chiorino
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Elisabetta Petracci
- Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Emir Sehovic
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy.
- Department of Life Sciences and Systems Biology, University of Turin, Turin, Italy.
| | - Ilaria Gregnanin
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Elisa Camussi
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Maurizia Mello-Grand
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Paola Ostano
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia, Via Malta 3, 13900, Biella, Italy
| | - Emilia Riggi
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Viviana Vergini
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Alessia Russo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Enrico Berrino
- Department of Medical Sciences, University of Turin, Turin, Italy
- Pathology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy
| | - Andrea Ortale
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Francesca Garena
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Tiziana Venesio
- Pathology Unit, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy
| | - Federica Gallo
- Epidemiology Unit, Staff Health Direction, Local Health Authority 1 of Cuneo, Cuneo, Italy
| | | | - Alfonso Frigerio
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Nereo Segnan
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy.
| | - Livia Giordano
- SSD Epidemiologia Screening, CPO-AOU Città della Salute e della Scienza di Torino, Via Camillo Benso Di Cavour 31, 10123, Turin, Italy
| |
Collapse
|
5
|
de Jonge L, Riggi E, van Duuren LA, Toes-Zoutendijk E, Campari C, Sassatelli R, Arrigoni A, Orione L, Lansdorp-Vogelaar I, Senore C. Risk prediction for advanced neoplasia using longitudinal adherence measures to fecal immunochemical test-based colorectal cancer screening programs. Prev Med 2023; 170:107488. [PMID: 36931473 DOI: 10.1016/j.ypmed.2023.107488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/12/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Patterns of longitudinal adherence may predict advanced neoplasia (AN) detection in subsequent rounds of colorectal cancer (CRC) screening. However, after more than five rounds, it is important to obtain a simplified measure. The aim was to determine the best simplified measure of longitudinal adherence to predict AN detection in CRC screening. METHODS Individuals with four invitations from a Dutch Fecal immunochemical testing (FIT-)based pilot study and two Italian FIT-based CRC screening programs were included. We calculated AN detection in the fourth round, stratified by prior adherence. Five simplified measures were compared to full information (permutations) using chi-squared goodness-of-fit: adherence previous invitation, consistency, frequency, frequency + adherence previous invitation, and proportion of invitations covered. RESULTS AN detection in the fourth round was highly dependent on prior adherence behavior. For inconsistent adherence, detection in the fourth round was strongly dependent on frequency and time since last participation. The performance of the simplified measures to capture this variation differed considerably. 'Adherence previous invitation' scored worst in predicting AN detection. 'Frequency+adherence previous invitation' had lowest chi-squared goodness-of-fit. DISCUSSION The simplified measure 'frequency+adherence previous invitation' is the best measure to reflect patterns of longitudinal adherence and could be used to emphasize to individuals the importance of CRC screening.
Collapse
Affiliation(s)
- L de Jonge
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Emilia Riggi
- Epidemiology and Screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Luuk A van Duuren
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Esther Toes-Zoutendijk
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Cinzia Campari
- Screening Unit, AUSL IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Romano Sassatelli
- Gastroenterology and Digestive Endoscopy Unit, IRCCS Santa Maria Nuova, Reggio Emilia, Italy
| | - Arrigo Arrigoni
- Diagnostic and Interventional Digestive Endoscopy, FPO-IRCCS Candiolo Cancer Institute, Turin, Italy
| | - Lorenzo Orione
- Screening organisation and evaluation Unit, ASL CN1, Cuneo, Italy
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Carlo Senore
- Epidemiology and Screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| |
Collapse
|
6
|
Fazia T, Bubbico F, Nova A, Riggi E, Caimi G, Calgan B, Salvato G, Bruno S, Bottini G, Bernardinelli L. Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety. Front Psychol 2022; 13:914183. [PMID: 35859847 PMCID: PMC9289612 DOI: 10.3389/fpsyg.2022.914183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022] Open
Abstract
To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre–post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (β = −8.24 [95%CI −15.39; −1.09], p = 0.02) and WEMWBS (β = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.
Collapse
Affiliation(s)
- Teresa Fazia
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Teresa Fazia
| | - Francesco Bubbico
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Andrea Nova
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Emilia Riggi
- SSD Epidemiologia e Screening CPO, Universital Hospital “Città della Salute e della Scienza di Torino”, Torino, Italy
| | - Giancarlo Caimi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Beril Calgan
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gerardo Salvato
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Cognitive Neuropsychology Centre, ASST “Grande Ospedale Metropolitano” Niguarda, Milan, Italy
| | | | - Gabriella Bottini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Cognitive Neuropsychology Centre, ASST “Grande Ospedale Metropolitano” Niguarda, Milan, Italy
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
7
|
Riggi E, Baccini M, Camussi E, Gallo F, Anatrone C, Pezzana A, Senore C, Giordano L, Segnan N. Promoting healthy lifestyle habits among participants in cancer screening programs: Results of the randomized controlled Sti.Vi study. J Public Health Res 2022; 11:22799036221106542. [PMID: 35928498 PMCID: PMC9343860 DOI: 10.1177/22799036221106542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Unhealthy diets, physical inactivity, alcohol and tobacco consumption are among the leading risk factors for non-communicable diseases. It is estimated that around 40% of cancers could be prevented by adopting healthy lifestyles. Design and methods: The Stili di Vita (Sti.Vi) study was a randomized study for assessing the impact of healthy lifestyle interventions on anthropometric measures, metabolic parameters, and health outcomes among participants of cancer screening programs in Turin (Italy). Eligible women aged 50–54 years, invited to biennial mammography screening, and 58-years-old men and women, invited to a once-only sigmoidoscopy for colorectal cancer (CRC) screening were randomly allocated to Diet group (DG), Physical Activity group (PAG), Physical Activity plus Diet group (PADG), or control group (CG). Physical and eating habits, metabolic and anthropometric measurements, repeatedly collected, were the study outcomes. The active intervention, offered to participants assigned to the DG, PAG, and PADG arms, consisted of a basic module and an advanced module. The effect of the interventions was estimated through logistic regression or a difference in differences approach. A multiple imputation procedure was implemented to deal with missing values and q-values have been calculated in the presence of multiple hypothesis testing. Results: Out of the 8442 screened attendees, 1270 signed informed consent, while 1125 participants accomplished the baseline visit. Participants were equally distributed across the four treatments as following: 273 (24.3%) in DG, 288 (25.6%) in the PAG, 283 (25.1%) in PADG, and 281 (25%) in the CG. Participants assigned to DG or PADG increased their consumption of whole grains (OR = 1.77, 95% CI: 1.20–2.60 and OR = 1.55, 95% CI: 1.06–2.27, respectively) and legumes (OR = 1.77, 95% CI: 1.12–2.79 and OR = 2.24, 95% CI: 1.41–3.57, respectively), with respect to CG. The participants randomized to DG reduced processed meat and increased fruit consumption (OR = 2.57, 95% CI: 1.76–3.76 and OR = 2.38, 95% CI: 1.12–5.06, respectively). The effects were more evident in the CRC screening subgroup. No relevant difference was observed between PAG and CG. No impact was observed on physical activity habits. Conclusions: Our findings suggest that active interventions can increase awareness and induce diet changes. However, participation rate and compliance to the courses was quite low, innovative strategies to enhance participants’ retention are needed, with the ultimate goal of increasing awareness and inducing positive lifestyle changes.
Collapse
Affiliation(s)
- Emilia Riggi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Elisa Camussi
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Federica Gallo
- Epidemiology Unit, Staff Health Direction, Local Health Authority 1 of Cuneo, Cuneo, Italy
| | - Caterina Anatrone
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Andrea Pezzana
- Dietetics and Clinical Nutrition Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Carlo Senore
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Livia Giordano
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Nereo Segnan
- S.S.D. Epidemiologia Screening – CPO. AOU Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
8
|
Armaroli P, Frigerio A, Correale L, Ponti A, Artuso F, Casella D, Falco P, Favettini E, Fonio P, Giordano L, Marra V, Milanesio L, Morra L, Presti P, Riggi E, Vergini V, Segnan N. A randomised controlled trial of digital breast tomosynthesis vs digital mammography as primary screening tests: Screening results over subsequent episodes of the Proteus Donna study. Int J Cancer 2022; 151:1778-1790. [PMID: 35689673 DOI: 10.1002/ijc.34161] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/06/2022]
Abstract
Proteus Donna is a randomised controlled trial aimed at prospectively evaluating screening with digital breast tomosynthesis (DBT), including interval cancer detection (ICD) and cancer detection (CD) in the analysis as a cumulative measure over subsequent screening episodes. Consenting women aged 46 to 68 attending the regional Breast Screening Service were randomly assigned to conventional digital mammography (DM, control arm) or DBT in addition to DM (DBT, study arm). At the subsequent round all participants underwent DM. Thirty-six months follow-up allowed for the identification of cancers detected in the subsequent screening and interscreening interval. Relative risk (RR) and 95% confidence interval (95% CI) were computed. Cumulative CD and Nelson-Aalen incidence were analysed over the follow-up period. Between 31 December 2014 and 31 December 2017, 43 022 women were randomised to DM and 30 844 to DBT. At baseline, CD was significantly higher (RR: 1.44, 95% CI: 1.21-1.71) in the study arm. ICD did not differ significantly between the two arms (RR: 0.92, 95% CI: 0.62-1.35). At subsequent screening with DM, the CD was lower (nearly significant) in the study arm (RR: 0.83, 95% CI: 0.65-1.06). Over the follow-up period, the cumulative CD (comprehensive of ICD) was slightly higher in the study arm (RR: 1.15, 95% CI: 1.01-1.31). The Nelson-Aalen cumulative incidence over time remained significantly higher in the study arm for approximately 24 months. Benign lesions detection was higher in the study arm at baseline and lower at subsequent tests. Outcomes are consistent with a lead time gain of DBT compared to DM, with an increase in false positives and moderate overdiagnosis.
Collapse
Affiliation(s)
- Paola Armaroli
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Alfonso Frigerio
- S.S.D. Senologia di Screening, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Loredana Correale
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio Ponti
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Franca Artuso
- S.S.D. Senologia di Screening, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Denise Casella
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Paolo Fonio
- Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Livia Giordano
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Vincenzo Marra
- S.C. Radiologia Sant'Anna, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Luisella Milanesio
- S.S.D. Senologia di Screening, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Lia Morra
- Dipartimento di Automatica e Informatica, Politecnico di Torino, Turin, Italy
| | | | - Emilia Riggi
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Viviana Vergini
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Nereo Segnan
- S.S.D. Epidemiologia Screening, CPO AOU Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
9
|
Senore C, Riggi E, Armaroli P, Bonelli L, Sciallero S, Zappa M, Arrigoni A, Casella C, Crosta C, Falcini F, Ferrero F, Fracchia M, Giuliani O, Risio M, Russo AG, Visioli CB, Rosso S, Segnan N. Long-Term Follow-up of the Italian Flexible Sigmoidoscopy Screening Trial. Ann Intern Med 2022; 175:36-45. [PMID: 34748376 DOI: 10.7326/m21-0977] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Recent reports showed that the protective effect of flexible sigmoidoscopy (FS) screening was maintained up to17 years, although differences were reported by sex. OBJECTIVE To assess long-term reduction of colorectal cancer (CRC) incidence and mortality after a single FS screening. DESIGN Parallel randomized controlled trial. (ISRCTN registry number: 27814061). SETTING 6 centers in Italy. PARTICIPANTS Persons aged 55 to 64 years expressing interest in having FS screening if invited, recruited from 1995 to 1999 and followed until 2012 (incidence) and 2014 to 2016 (mortality). INTERVENTION Eligible persons were randomly assigned (1:1 ratio) to either the once-only FS screening group or control (usual care) group. MEASUREMENTS Incidence and mortality rate ratios (RRs) and rate differences. RESULTS A total of 34 272 persons (17 136 in each group) were included in the analysis; 9911 participants had screening in the intervention group. Median follow-up was 15.4 years for incidence and 18.8 years for mortality. Incidence of CRC was reduced by 19% (RR, 0.81 [95% CI, 0.71 to 0.93]) in the intention-to-treat (ITT) analysis, comparing the intervention with the control group, and by 33% (RR, 0.67 [CI, 0.56 to 0.81]) in the per protocol (PP) analysis, comparing participants screened in the intervention group with the control persons. Colorectal cancer mortality was reduced by 22% (RR, 0.78 [CI, 0.61 to 0.98]) in the ITT analysis and by 39% (RR, 0.61 [CI, 0.44 to 0.84]) in the PP analysis. Incidence of CRC was statistically significantly reduced among both men and women. Colorectal cancer mortality was statistically significantly reduced among men (ITT RR, 0.73 [CI, 0.54 to 0.97]) but not among women (ITT RR, 0.90 [CI, 0.59 to 1.37]). LIMITATION Self-selection of volunteers from the general population sample targeted for recruitment may limit generalizability. CONCLUSION The strong protective effect of a single FS screening for CRC incidence and mortality was maintained up to 15 and 19 years, respectively. PRIMARY FUNDING SOURCE Italian Association for Cancer Research, Italian National Research Council, Istituto Oncologico Romagnolo, Fondo "E. Tempia," University of Milan, and Local Health Unit ASL-Torino.
Collapse
Affiliation(s)
- Carlo Senore
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Emilia Riggi
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Paola Armaroli
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | - Luigina Bonelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy (L.B., S.S., C.C.)
| | | | | | | | - Claudia Casella
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy (L.B., S.S., C.C.)
| | | | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Meldola, Forlì, Italy (F.F., O.G.)
| | | | | | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Meldola, Forlì, Italy (F.F., O.G.)
| | - Mauro Risio
- FPO-IRCCS Candiolo Cancer Institute, Turin, Italy (M.R.)
| | - Antonio G Russo
- Agency for Health Protection of the Metropolitan Area of Milan, Milan, Italy (A.G.R.)
| | | | - Stefano Rosso
- Piedmont Cancer Registry, University Hospital Città della Salute e della Scienza, Turin, Italy (S.R.)
| | - Nereo Segnan
- University Hospital Città della Salute e della Scienza, Turin, Italy (C.S., E.R., P.A., N.S.)
| | | |
Collapse
|
10
|
Piccinelli C, Rousset S, Riggi E, Albonico M, Araldi M, Milano M, Rossi P, Ferrante G, Giordano L, Senore C. Predictive values of symptoms for SARS-CoV-2 infection among primary care patients in Piedmont. Epidemiol Prev 2021; 45:543-551. [PMID: 34897069 DOI: 10.19191/ep21.6.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES to investigate the combinations of clinical features and symptoms that best predict the positive outcome of the SARS-CoV-2 swab in a primary care setting. DESIGN prospective cohort study. SETTING AND PARTICIPANTS patients listed in the rosters of general practitioners volunteering for the study who reported flu-like symptoms and/or anosmia/ageusia between 01.03.2020 and 30.06.2020. MAIN OUTCOME MEASURES positive molecular swab result. The predictive value of the reported symptoms and their association with this outcome were estimated using multivariable logistic regression models, adopting an inverse probability weighting approach. RESULTS a swab was requested for 1,045 (77.2%) out of 1,354 patients included in the study: 79.6% of them were tested, with a positive result in 50.4% of cases. Patients aged 40 to 64 years (OR 1.59; 95%CI 1.09-2.33) and those older than 64 years (OR 2.64; 95%CI 1.66-4.19) showed a higher likelihood of a positive swab results, compared with younger subjects (<40 years). A positive association with a positive swab result was observed among patients reporting fever >37.5°C (OR 1.67; 95%CI: 1.18-2.36) and anosmia/ageusia (OR 1.44; 95%CI: 1.01-2.04). The predictive value of fever tended to increase with increasing age, while an opposite trend was observed for anosmia/ageusia. No difference by gender was observed. CONCLUSIONS among patients reporting flu-like symptoms in a general practice setting, fever >37.5 and anosmia/ageusia were predictive of a positive SARS-CoV-2 swab test result and this association was modified by age. Although the generalizability of these findings might be limited, this study highlights the importance of the contribution of the research conducted in primary care settings to the definition of effective and sustainable strategies to contrast the pandemic emergency.
Collapse
Affiliation(s)
- Cristiano Piccinelli
- SSD epidemiologia e screening, CPO-AOU Città della salute e della scienza di Torino, Turin (Italy);
| | - Stefano Rousset
- SSD epidemiologia e screening, CPO-AOU Città della salute e della scienza di Torino, Turin (Italy)
| | - Emilia Riggi
- SSD epidemiologia e screening, CPO-AOU Città della salute e della scienza di Torino, Turin (Italy)
| | | | - Marco Araldi
- Azienda sanitaria locale Città di Torino, Turin (Italy)
- Società italiana medicina generale
| | - Maria Milano
- Azienda sanitaria locale Torino 3, Grugliasco (Italy)
- Società italiana medicina generale
- Società italiana pedagogia medica
| | - PierRiccardo Rossi
- Azienda sanitaria locale Città di Torino, Turin (Italy)
- Società italiana medicina generale
- Società italiana pedagogia medica
| | | | | | - Carlo Senore
- Azienda sanitaria locale Città di Torino, Turin (Italy)
| |
Collapse
|
11
|
Hanna N, Purohit M, Diwan V, Chandran SP, Riggi E, Parashar V, Tamhankar AJ, Lundborg CS. Monitoring of Water Quality, Antibiotic Residues, and Antibiotic-Resistant Escherichia coli in the Kshipra River in India over a 3-Year Period. Int J Environ Res Public Health 2020; 17:ijerph17217706. [PMID: 33105585 PMCID: PMC7659961 DOI: 10.3390/ijerph17217706] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
The emergence of antibiotic resistance is a major global and environmental health issue, yet the presence of antibiotic residues and resistance in the water and sediment of a river subjected to excessive anthropogenic activities and their relationship with water quality of the river are not well studied. The objectives of the present study were a) to investigate the occurrence of antibiotic residues and antibiotic-resistant Escherichia coli (E. coli) in the water and sediment of the Kshipra river in India at seven selected sites during different seasons of the years 2014, 2015, and 2016 and b) to investigate the association between antibiotic residues and antibiotic-resistant E. coli in water and sediment and measured water quality parameters of the river. Antibiotic residues and resistant E. coli were present in the water and sediment and were associated with the measured water quality parameters. Sulfamethoxazole was the most frequently detected antibiotic in water at the highest concentration of 4.66 µg/L and was positively correlated with the water quality parameters. Significant (p < 0.05) seasonal and spatial variations of antibiotic-resistant E. coli in water and sediment were found. The resistance of E. coli to antibiotics (e.g., sulfamethiazole, norfloxacin, ciprofloxacine, cefotaxime, co-trimoxazole, ceftazidime, meropenem, ampicillin, amikacin, metronidazole, tetracycline, and tigecycline) had varying associations with the measured water and sediment quality parameters. Based on the results of this study, it is suggested that regular monitoring and surveillance of water quality, including antibiotic residues and antibiotic resistance, of all rivers should be taken up as a key priority, in national and Global Action Plans as these can have implications for the buildup of antibiotic resistance.
Collapse
Affiliation(s)
- Nada Hanna
- Department of Global Public Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (A.J.T.); (C.S.L.)
- Correspondence: (N.H.); (M.P.)
| | - Manju Purohit
- Department of Global Public Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (A.J.T.); (C.S.L.)
- Department of Pathology, R.D. Gardi Medical College, Ujjain 456006, India
- Correspondence: (N.H.); (M.P.)
| | - Vishal Diwan
- Department of Global Public Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (A.J.T.); (C.S.L.)
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India;
- ICMR—National Institute for Research in Environmental Health, Bhopal 462030, India
| | | | - Emilia Riggi
- SSD Epidemiologia screening—CPO, University Hospital ‘Cittàdella Salute della Scienza’, 10126 Turin, Italy;
| | - Vivek Parashar
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India;
| | - Ashok J. Tamhankar
- Department of Global Public Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (A.J.T.); (C.S.L.)
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India
| | - Cecilia Stålsby Lundborg
- Department of Global Public Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.D.); (A.J.T.); (C.S.L.)
| |
Collapse
|
12
|
Armaroli P, Riggi E, Basu P, Anttila A, Ponti A, Carvalho AL, Dillner J, Elfström MK, Giordano L, Lönnberg S, Ronco G, Senore C, Soerjomataram I, Tomatis M, Vale DB, Jarm K, Sankaranarayanan R, Segnan N. Performance indicators in breast cancer screening in the European Union: A comparison across countries of screen positivity and detection rates. Int J Cancer 2020; 147:1855-1863. [PMID: 32159224 DOI: 10.1002/ijc.32968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/05/2020] [Accepted: 02/24/2020] [Indexed: 01/19/2023]
Abstract
Comparable performance indicators for breast cancer screening in the European Union (EU) have not been previously reported. We estimated adjusted breast cancer screening positivity rate (PR) and detection rates (DR) to investigate variation across EU countries. For the age 50-69 years, the adjusted EU-pooled PR for initial screening was 8.9% (cross-programme variation range 3.2-19.5%) while DR of invasive cancers was 5.3/1,000 (range 3.8-7.4/1,000) and DR of ductal carcinoma in situ (DCIS) was 1.3/1,000 (range 0.7-2.7/1,000). For subsequent screening, the adjusted EU-pooled PR was 3.6% (range 1.4-8.4%), the DR was 4.0/1,000 (range 2.2-5.8/1,000) and 0.8/1,000 (range 0.5-1.3/1,000) for invasive and DCIS, respectively. Adjusted performance indicators showed remarkable heterogeneity, likely due to different background breast cancer risk and awareness between target populations, and also different screening protocols and organisation. Periodic reporting of the screening indicators permits comparison and evaluation of the screening activities between and within countries aiming to improve the quality and the outcomes of screening programmes. Cancer Screening Registries would be a milestone in this direction and EU Screening Reports provide a fundamental contribution to building them.
Collapse
Affiliation(s)
- Paola Armaroli
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Emilia Riggi
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Partha Basu
- Screening Group, International Agency for Research on Cancer, Lyon, France
| | - Ahti Anttila
- Mass Screening Registry, Finish Cancer Registry, Helsinki, Finland
| | - Antonio Ponti
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Andre L Carvalho
- Screening Group, International Agency for Research on Cancer, Lyon, France
| | - Joakim Dillner
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Miriam K Elfström
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Livia Giordano
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Stefan Lönnberg
- Mass Screening Registry, Finish Cancer Registry, Helsinki, Finland
| | - Gugliemo Ronco
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
- International Agency for Research on Cancer, Lyon, France
| | - Carlo Senore
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mariano Tomatis
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| | - Diama B Vale
- Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, Brazil
| | - Katja Jarm
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Nereo Segnan
- 'AOU Città della Salute e della Scienza' University Hospital, CPO Piemonte, Turin, Italy
| |
Collapse
|
13
|
Senore C, Zappa M, Campari C, Crotta S, Armaroli P, Arrigoni A, Cassoni P, Colla R, Fracchia M, Gili F, Grazzini G, Lolli R, Menozzi P, Orione L, Polizzi S, Rapi S, Riggi E, Rubeca T, Sassatelli R, Visioli C, Segnan N. Faecal haemoglobin concentration among subjects with negative FIT results is associated with the detection rate of neoplasia at subsequent rounds: a prospective study in the context of population based screening programmes in Italy. Gut 2020; 69:523-530. [PMID: 31455608 DOI: 10.1136/gutjnl-2018-318198] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To estimate the predictive role of faecal haemoglobin (f-Hb) concentration among subjects with faecal immunochemical test (FIT) results below the positivity cut-off for the subsequent risk of advanced neoplasia (AN: colorectal cancer-CRC-or advanced adenoma). DESIGN Prospective cohort of subjects aged 50-69 years, undergoing their first FIT between 1 January 2004 and 31 December 2010 in four population-based programmes in Italy. METHODS All programmes adopted the same analytical procedure (OC Sensor, Eiken Japan), performed every 2 years, on a single sample, with the same positivity cut-off (20 µg Hb/g faeces). We assessed the AN risk at subsequent exams, the cumulative AN detection rate (DR) over the 4-year period following the second FIT and the interval CRC (IC) risk following two negative FITs by cumulative amount of f-Hb concentration over two consecutive negative FITs, using multivariable logistic regression models and the Kaplan-Meier method. RESULTS The cumulative probability of a positive FIT result over the subsequent two rounds ranged between 7.8% (95% CI 7.5 to 8.2) for subjects with undetectable f-Hb at the initial two tests (50% of the screenees) and 48.4% (95% CI 44.0 to 53.0) among those (0.7% of the screenees) with a cumulative f-Hb concentration ≥20 µg/g faeces. The corresponding figures for cumulative DR were: 1.4% (95% CI 1.3 to 1.6) and 25.5% (95% CI 21.4 to 30.2) for AN; 0.17% (95% CI 0.12 to 0.23) and 4.5% (95% CI 2.8 to 7.1) for CRC. IC risk was also associated with cumulative f-Hb levels. CONCLUSION The association of cumulative f-Hb concentration with subsequent AN and IC risk may allow to design tailored strategies to optimise the utilisation of endoscopy resources: subjects with cumulative f-Hb concentration ≥20 µg/g faeces over two negative tests could be referred immediately for total colonoscopy (TC), while screening interval might be extended for those with undetectable f-Hb.
Collapse
Affiliation(s)
- Carlo Senore
- SSD Epidemiologia e screening - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Marco Zappa
- Clinical Epidemiology Unit, ISPRO, Florence, Italy
| | - Cinzia Campari
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Paola Armaroli
- SSD Epidemiologia e screening - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Arrigo Arrigoni
- University Gastroenterology Unit, Ospedale San Giovanni Antica Sede, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Universita degli Studi di Torino, Turin, Italy
| | - Rossana Colla
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mario Fracchia
- Gastroenterology Unit, Mauriziano Umberto I Hospital, Turin, Italy
| | - Fabrizio Gili
- Colorectal Cancer Screening Laboratory, University Hospital Città della Salute e della Scienza, Turin, Italy
| | | | - Roberto Lolli
- Gastroenterology Unit, Regional Hospital, Aosta, Italy
| | | | | | | | | | - Emilia Riggi
- SSD Epidemiologia e screening - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| | | | | | | | - Nereo Segnan
- SSD Epidemiologia e screening - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy
| |
Collapse
|
14
|
Pecere S, Senore C, Hassan C, Riggi E, Segnan N, Pennazio M, Sprujievnik T, Rondonotti E, Baccarin A, Quintero E, Adrian de Ganzo Z, Costamagna G, Spada C. Accuracy of colon capsule endoscopy for advanced neoplasia. Gastrointest Endosc 2020; 91:406-414.e1. [PMID: 31629719 DOI: 10.1016/j.gie.2019.09.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/27/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Second-generation colon capsule endoscopy (CCE-2) has shown promising accuracy for the diagnosis of overall neoplasia. Advanced neoplasia (AN) represents the main target of colorectal cancer screening programs. Our aim was to assess the diagnostic accuracy of CCE-2 for the detection of AN in patients with a positive result for the fecal immunochemical test (FIT) who are undergoing screening. METHODS Patients aged 50 to 69 years with a positive result for the FIT in 4 population screening programs in Italy and Spain were enrolled. Screenees were asked to undergo CCE-2, followed by traditional colonoscopy (TC). TC was performed the same day or the following morning. Bowel preparation included a split-dose polyethylene glycol-based regimen, with sodium phosphate (NaP) with gastrografin as boosters. The CCE-2 video was read by an endoscopist blinded to the results of TC. The main outcomes were CCE-2 accuracy in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for AN when using 2 different size thresholds for TC referral (ie, polyps ≥6 mm and ≥10 mm). RESULTS Two hundred twenty-two patients were enrolled, and 178 patients completed both CCE-2 and TC (87.7%). Overall, 59 cases of AN were detected at TC. CCE-2 sensitivity was 90%, specificity was 66.1%, PPV was 57.4%, and NPV was 92.9% for AN when using a 6-mm cut-off (TC referral rate, 52.8%) and 76.7%, 90.7%, 80.7%, and 88.4% when using a 10-mm cut-off (TC referral rate, 32%), respectively. CCE-2 detected that 8 of 9 already developed colorectal cancers. Among the 41 false positives at the 6-mm cut-off, 34 (82.9%) presented with a nonadvanced adenoma at TC. Mean transit time was 4 hours and 4 minutes, and ≥70% of patients excreted the capsule within 5 hours. CONCLUSIONS In an enriched disease setting, we showed the high sensitivity of CCE-2 for the diagnosis of AN at a 6-mm cut-off. The apparently low CCE-2 specificity is related to the choice of AN as the main outcome. (Clinical trial registration number: ISRCTN 62158762.).
Collapse
Affiliation(s)
- Silvia Pecere
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Catholic University, Rome, Italy
| | - Carlo Senore
- Epidemiology and Screening Unit - CPO, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Cesare Hassan
- Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Emilia Riggi
- Epidemiology and Screening Unit - CPO, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Nereo Segnan
- Epidemiology and Screening Unit - CPO, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Marco Pennazio
- University Gastroenterology Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Tatiana Sprujievnik
- University Gastroenterology Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | | | | | - Enrique Quintero
- Servicio de Gastroenterologia, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Departamento de Medicina Interna, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - Zaida Adrian de Ganzo
- Servicio de Gastroenterologia, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Departamento de Medicina Interna, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Catholic University, Rome, Italy
| | - Cristiano Spada
- Digestive Endoscopy Unit. Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
15
|
Zocchi J, Pietrobon G, Campomagnani I, Riggi E, Veronesi G, Borchini R, Pellini R, Volpi L, Bignami M, Castelnuovo P. The role of a post therapeutic surveillance program for sinonasal malignancies: Analysis of 417 patients. Head Neck 2019; 42:963-973. [PMID: 31889395 DOI: 10.1002/hed.26069] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 10/08/2019] [Accepted: 12/19/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Post therapeutic surveillance of head and neck neoplasms is a still debated issue in the current literature: although different works tried to establish frequency, modality, and efficacy of a routine follow-up, little evidence has been produced, in particular considering only sinonasal malignancies. METHODS A retrospective review of patients treated for sinonasal malignancies in a single tertiary center and followed through a regular program of follow-up was carried out. Rate of recurrence, location, timing, diagnosis, and salvage treatment were the main data analyzed. RESULTS Of note, 417 patients were included in the study and 117 experienced at least one relapse. Staging, histological type, and previous treatment represent the main clinical factors to be considered to stratify patient's risk of recurrence. CONCLUSION A regular post therapeutic surveillance can provide an early recurrence detection for patients treated for sinonasal malignancies, offering opportunity for salvage treatment in a high percentage of patients.
Collapse
Affiliation(s)
- Jacopo Zocchi
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Giacomo Pietrobon
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Isotta Campomagnani
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Emilia Riggi
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria.,SSD Epidemiology and Screening-CPO, University Hospital "Città della Salute e della Scienza", Turin, Italy
| | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria
| | - Rossana Borchini
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Luca Volpi
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| |
Collapse
|
16
|
Senore C, Basu P, Anttila A, Ponti A, Tomatis M, Vale DB, Ronco G, Soerjomataram I, Primic-Žakelj M, Riggi E, Dillner J, Elfström MK, Lönnberg S, Sankaranarayanan R, Segnan N. Performance of colorectal cancer screening in the European Union Member States: data from the second European screening report. Gut 2019; 68:1232-1244. [PMID: 30530530 DOI: 10.1136/gutjnl-2018-317293] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To present comparative data about the performance of colorectal cancer (CRC) screening programmes in the European Union Member States (EU MSs). DESIGN Cross-sectional study. We analysed key performance indicators-participation rate, positivity rate (PR), detection rate (DR) and positive predictive value for adenomas and CRC-based on the aggregated quantitative data collected for the second EU screening report. We derived crude and pooled (through a random effects model) estimates to describe and compare trends across different MSs/regions and screening protocols. RESULTS Participation rate was higher in countries adopting faecal immunochemical test (FIT) (range: 22.8%-71.3%) than in those using guaiac faecal occult blood test (gFOBT) (range 4.5%-66.6%), and it showed a positive correlation (ρ=0.842, p<0.001) with participation in breast cancer screening in the same areas. Screening performance showed a large variability. Compliance with referral for colonoscopy (total colonoscopy (TC)) assessment ranged between 64% and 92%; TC completion rate ranged between 92% and 99%. PR and DR of advanced adenomas and CRC were higher in FIT, as compared with gFOBT programmes, and independent of the protocol among men, older subjects and those performing their first screening. CONCLUSIONS The variability in the results of quality indicators across population-based screening programmes highlights the importance of continuous monitoring, as well as the need to promote quality improvement efforts, as recommended in the EU guidelines. The implementation of monitoring systems, ensuring availability of data for the entire process, together with initiatives aimed to enhance reproducibility of histology and quality of endoscopy, represent a priority in screening programmes management.
Collapse
Affiliation(s)
- Carlo Senore
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Partha Basu
- Screening Group, International Agency for Research on Cancer, Lyon, France
| | - Ahti Anttila
- Mass Screening Registry/Finnish Cancer Registry, Finnish Cancer Registry, Helsinki, Finland
| | - Antonio Ponti
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Mariano Tomatis
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Diama Bhadra Vale
- Department of Obstetrics and Gynecology, State University of Campinas (Unicamp), Campinas, Brazil, Campinas, Brazil
| | - Gugliemo Ronco
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | | | - Emilia Riggi
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| | | | | | | | | | - Nereo Segnan
- SSD Epidemiologia e screening - CPO, University Hospital 'Città della Salute e della Scienza', Turin, Italy
| |
Collapse
|
17
|
Diwan V, Hanna N, Purohit M, Chandran S, Riggi E, Parashar V, Tamhankar AJ, Stålsby Lundborg C. Seasonal Variations in Water-Quality, Antibiotic Residues, Resistant Bacteria and Antibiotic Resistance Genes of Escherichia coli Isolates from Water and Sediments of the Kshipra River in Central India. Int J Environ Res Public Health 2018; 15:E1281. [PMID: 29914198 PMCID: PMC6024939 DOI: 10.3390/ijerph15061281] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To characterize the seasonal variation, over one year, in water-quality, antibiotic residue levels, antibiotic resistance genes and antibiotic resistance in Escherichia coli isolates from water and sediment of the Kshipra River in Central India. METHODS Water and sediment samples were collected from seven selected points from the Kshipra River in the Indian city of Ujjain in the summer, rainy season, autumn and winter seasons in 2014. Water quality parameters (physical, chemical and microbiological) were analyzed using standard methods. High-performance liquid chromatography⁻tandem mass spectrometry was used to determine the concentrations of antibiotic residues. In river water and sediment samples, antibiotic resistance and multidrug resistance patterns of isolated E. coli to 17 antibiotics were tested and genes coding for resistance and phylogenetic groups were detected using multiplex polymerase chain reaction. One-way analysis of variance (ANOVA) and Fisher tests were applied to determine seasonal variation. RESULTS In river water, seasonal variation was significantly associated with various water quality parameters, presence of sulfamethoxazole residues, bacteria resistant to ampicillin, cefepime, meropenem, amikacin, gentamicin, tigecycline, multidrug resistance and CTX-M-1 gene. The majority of the Extended Spectrum Beta-Lactamase (ESBL)-producing E. coli isolates from river water and sediment in all different seasons belonged to phylogenetic group A or B1. CONCLUSIONS Antibiotic pollution, resistance and resistance genes in the Kshipra River showed significant seasonal variation. Guidelines and regulatory standards are needed to control environmental dissemination of these “pollutants” in this holy river.
Collapse
Affiliation(s)
- Vishal Diwan
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India.
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Stockholm 171 77, Sweden.
- International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain 456001, India.
| | - Nada Hanna
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Stockholm 171 77, Sweden.
| | - Manju Purohit
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Stockholm 171 77, Sweden.
- Department of Pathology, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Salesh Chandran
- HLL Biotech Ltd., Integrated Vaccines Complex, Melaripakkam (Post), Thirukalukundram Taluk, Chengalpattu 603001, India.
| | - Emilia Riggi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia 27100, Italy.
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese 21100, Italy.
| | - Vivek Parashar
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Ashok J Tamhankar
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Stockholm 171 77, Sweden.
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Cecilia Stålsby Lundborg
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, Stockholm 171 77, Sweden.
| |
Collapse
|
18
|
Lien LTQ, Chuc NTK, Hoa NQ, Lan PT, Thoa NTM, Riggi E, Tamhankar AJ, Lundborg CS. Staff knowledge and practice of infection control in one rural and one urban hospital in Vietnam. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - NTK Chuc
- Hanoi Medical University, Hanoi, Vietnam
| | - NQ Hoa
- National Cancer Institute, Hanoi, Vietnam
| | - PT Lan
- Hanoi Medical University, Hanoi, Vietnam
| | - NTM Thoa
- Hanoi Medical University, Hanoi, Vietnam
| | - E Riggi
- University of Pavia, Pavia, Italy
| | | | | |
Collapse
|
19
|
Le NK, Riggi E, Marrone G, Izurieta RO, Larsson M, Cuong DD. Assessment of WHO immunologic criteria for identifying ART treatment failure in low-income settings. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- NK Le
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | - E Riggi
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, IT
| | - G Marrone
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, SE
| | - RO Izurieta
- Department Global Health, College of Public Health, University of South Florida, Tampa, USA
| | - M Larsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, SE
| | - DD Cuong
- Infectious Diseases Department, Bach Mai Hospital, Hanoi, Vietnam
| |
Collapse
|
20
|
Le NK, Riggi E, Marrone G, Vu TV, Izurieta RO, Nguyen CKT, Larsson M, Do CD. Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011. PLoS One 2017; 12:e0182688. [PMID: 28877173 PMCID: PMC5587312 DOI: 10.1371/journal.pone.0182688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/20/2017] [Indexed: 11/19/2022] Open
Abstract
Objective We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (ARV) drugs, age, and gender on the sensitivity and specificity of the WHO criteria. Methods We conducted a retrospective cohort study of 605 HIV-infected patients using data previously collected from a cluster randomized control trial study. We compared the sensitivity and specificity of CD4+ counts to the gold standard of virologic testing as a diagnostic test for ART failure at different time points of 12, 18, and 24 months. Results The sensitivity [95% confidence interval (CI)] of the WHO immunological criteria based on a viral load ≥ 1000 copies/mL was 12% (5%-23%), 14% (2%-43%), and 12.5% (2%-38%) at 12, 18, and 24 months, respectively. In the same order, the specificity was 93% (90%-96%), 98% (96%-99%), and 98% (96%-100%). The positive predictive values (PPV) at 12, 18, and 24 months were 22% (9%-40%), 20% (3%-56%), and 29% (4%-71%); the negative predictive values (NPV) at the same time points were 87% (84%-90%), 97% (95%-98%), and 96% (93%-98%). The stratified analysis revealed similar sensitivities and specificities. Conclusion The sensitivity of the WHO immunological criteria is poor, but the specificity is high. Although testing costs may increase, we recommend that Vietnam and other similar settings adopt viral load testing as the principal method for determining ART failure.
Collapse
Affiliation(s)
- Nicole K. Le
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Emilia Riggi
- Department of Brain and Behavioural Sciences, Medical Statistics Unit, University of Pavia, Pavia, Italy
| | - Gaetano Marrone
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Tam Van Vu
- Department of Infectious Diseases, Uong Bi General Hospital, Uong Bi, Quang Ninh, Vietnam
| | - Ricardo O. Izurieta
- Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, United States of America
| | | | - Mattias Larsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Cuong Duy Do
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Infectious Diseases Department, Bach Mai Hospital, Hanoi, Vietnam
- * E-mail:
| |
Collapse
|
21
|
Abstract
BACKGROUND Alcohol consumption is of global concern. However, drinking patterns and associated factors remain under-investigated, especially among low socioeconomic groups such as street laborers. OBJECTIVE Using the social cognitive model as a framework for the study we aimed to identify factors associated with risky alcohol consumption. METHODS In a cross-sectional study using structured questionnaires, 450 male street laborers searching for casual works in Hanoi, Vietnam were interviewed. A logistic regression was applied in order to detect predictors of risky alcohol drinking. RESULTS During the last month, 45% of the participants reported daily consumption while the other 55% consumed weekly or less. Among the drinkers (416 out of 450, 92%), 27% were identified as high-risk drinkers who reported more than 14 standard drinks per week, while only 8% were lifetime abstainers. The multivariable logistic regression showed that older age, higher income were positively associated with a higher likelihood of drinking alcohol, while high school level negatively. The environmental predictor was the higher level of peer connection. The association between drinking and risky behavior was found positive with regards to the number of sexual partners. CONCLUSIONS The study suggests that male street laborers are vulnerable to health risks. Decision makers should note that a significant proportion of this target group exceeds the guidelines for alcohol use and this should be included in future interventions or further research. A multisectoral approach together with an important strategy of education is needed to control alcohol use.
Collapse
Affiliation(s)
- Lamprini Mylona
- a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden
| | - Nguyen Van Huy
- b Department of Health Management and Organization , Hanoi Medical University , Hanoi , Vietnam
| | - Pham Nguyen Ha
- a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.,c The Global Fund Supported Project on HIV/AIDS , Hanoi , Vietnam
| | - Emilia Riggi
- d Department of Brain and Behavioral Sciences , University of Pavia , Pavia , Italy
| | - Gaetano Marrone
- a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
22
|
Smietniansky M, Gonzalez Zalazar E, Boietti B, Ardiles V, Cal M, Riggi E, Camera L, De Santibañes E. ASSOCIATION BETWEEN FRAILTY AND POSTOPERATIVE COMPLICATIONS IN PATIENTS UNDERGOING ABDOMINAL SURGERY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Smietniansky
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - E. Gonzalez Zalazar
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - B. Boietti
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - V. Ardiles
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - M. Cal
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - E. Riggi
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - L. Camera
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| | - E. De Santibañes
- Internal Medicine - Geriatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
| |
Collapse
|
23
|
Rondanelli M, Talluri J, Peroni G, Donelli C, Guerriero F, Ferrini K, Riggi E, Sauta E, Perna S, Guido D. Beyond Body Mass Index. Is the Body Cell Mass Index (BCMI) a useful prognostic factor to describe nutritional, inflammation and muscle mass status in hospitalized elderly?: Body Cell Mass Index links in elderly. Clin Nutr 2017; 37:934-939. [PMID: 28408051 DOI: 10.1016/j.clnu.2017.03.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/25/2016] [Accepted: 03/20/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND & AIM The aim of this study was to establish the effectiveness of Body Cell Mass Index (BCMI) as a prognostic index of (mal)nutrition, inflammation and muscle mass status in the elderly. METHODS A cross-sectional observational study has been conducted on 114 elderly patients (80 women and 34 men), with mean age equal to 81.07 ± 6.18 years. We performed a multivariate regression model by Structural Equation Modelling (SEM) framework. We detected the effects over a Mini Nutritional Assessment (MNA) stratification, by performing a multi-group multivariate regression model (via SEM) in two MNA nutritional strata, less and bigger (or equal) than 17. RESULTS BCMI had a significant effect on albumin (β = +0.062, P = 0.001), adjusting for the other predictors of the model as Body Mass Index (BMI), age, sex, fat mass and cognitive condition. An analogous result is maintained in MNA<17 stratum. BMI has confirmed to be a solid prognostic factor for both free fat mass (FFM) (β = +0.480, P < 0.001) and Skeletal Muscle Index (SMI) (β = +0.265, P < 0.001), assessed by DXA. BCMI also returned suggestive evidences (0.05 < P < 0.10) for both the effect on FFM and on SMI in overall sample. CONCLUSIONS The main result of this study is that the BCMI, compared to BMI, proved to be significantly related to an important marker as albumin in geriatric population. Then, assessing the BCMI could be a valuable, inexpensive, easy to perform tool to investigate the inflammation status of elderly patients.
Collapse
Affiliation(s)
- Mariangela Rondanelli
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia, Italy
| | - Jacopo Talluri
- Research and Clinical Investigation Department, Akern, Pontassieve, Italy
| | - Gabriella Peroni
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia, Italy.
| | - Chiara Donelli
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia, Italy
| | | | - Krizia Ferrini
- Istituto Europeo di Oncologia, Department of Experimental Oncology, Milan, Italy; University of Pavia, Department of Brain and Behavioral Sciences, Medical and Genomic Statistics Unit, Pavia, Italy
| | - Emilia Riggi
- University of Pavia, Department of Brain and Behavioral Sciences, Medical and Genomic Statistics Unit, Pavia, Italy
| | - Elisabetta Sauta
- University of Pavia, Department of Brain and Behavioral Sciences, Medical and Genomic Statistics Unit, Pavia, Italy
| | - Simone Perna
- University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, Pavia, Italy
| | - Davide Guido
- University of Pavia, Department of Brain and Behavioral Sciences, Medical and Genomic Statistics Unit, Pavia, Italy; University of Pavia, Department of Public Health, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, Pavia, Italy
| |
Collapse
|
24
|
Perna S, Riggi E, Porta B, Peroni G, Guerriero F, Sgarlata C, Rollone M, Pozzi R, Guido D, Rondanelli M. P350: Association between the phase angle with muscle mass and strength in sarcopenic elderly. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
25
|
Perna S, Sauta E, Riggi E, Peroni G, Guerriero F, Sgarlata C, Rollone M, Cuzzoni G, Guido D, Rondanelli M. P244: Effects of body composition and nutritional markers on fracture accident in elderly. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Perna S, Sauta E, Riggi E, Peroni G, Guerriero F, Sgarlata C, Rollone M, Donelli C, Guido D, Degli Agosti I, Rondanelli M, Faliva M, Naso M. P128: Effects of serum iron markers on functional outcomes in sarcopenic elderly. A cross-sectional study. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70302-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Perna S, Riggi E, Sauta E, Moncaglieri F, Barnabei L, Porta B, Guerriero F, Rollone M, Sgarlata C, Monteferraio F, Guido D, Rondanelli M. P351: Is serum creatinine correlated to risk of muscle loss in sarcopenic elderly men? The role of azotemia. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70515-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
28
|
Perna S, Guido D, Riggi E, Guerriero F, Sgarlata C, Sauta E, Rollone M, Oberto L, Maddalena D, Rondanelli M. P130: Erythrocyte sedimentation rate (ESR) and C-reactive protein (PCR) as inflammation markers in sarcopenic elderly. Repercussions on functional status. A cross-sectional study in nursing home residents. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|